SKELOS, J.
This appeal and cross appeal involve an action by the corporate plaintiffs—general contractors and residential home builders—against the defendant insurance company, from which the plaintiffs purchased a commercial general liability policy, and the underwriter of the policy. The plaintiffs' action is grounded, for the most part, on their claim that the defendants improperly charged a higher premium based upon the plaintiffs' employment of uninsured subcontractors, despite the fact that the policy excluded coverage for liability arising from the work of such subcontractors. The principal issue presented on this appeal is whether this claim is barred by the filed rate doctrine. We answer that question in the affirmative.
In connection with a residential construction project, the affiliated plaintiffs purchased a commercial general liability insurance policy (hereinafter the policy) from the defendant Everest National Insurance Company (hereinafter Everest). The policy was underwritten by the defendant Inter-Reco, Inc. (hereinafter Inter-Reco), and was issued pursuant to a "program," denominated the "Inter-Reco program," which provides commercial general liability insurance to contractors.
The policy contained an endorsement, entitled "Independent Contractors," by which the named insured agreed that independent contractors would have in force certificates of insurance from subcontractors, "providing evidence of like coverage" and containing "limits of liability ... at least equal to the limits of [the] policy." The policy further contained an exclusion from
At the beginning of the policy period, the plaintiffs paid an "advance or deposit" premium of $28,541, which was subject to a premium audit at the end of the one-year policy period to determine the final premium.
In general, in determining the amount of premium to charge contractors under the Inter-Reco program, the underwriter employs a classification system set forth in the Commercial Lines Manual prepared by the Insurance Services Office, Inc. (hereinafter ISO). The defendants assert, and the plaintiffs do not dispute, that the Commercial Lines Manual (hereinafter ISO Manual) is approved by the New York State Insurance Department (hereinafter Insurance Department). In employing the classification system, multiple class codes are assigned to an insured, and the class codes correspond to a "premium base" and rate, which is utilized to calculate the premium. "Premium base" refers to the basis on which the premium will be calculated, such as "total cost" of subcontracted work or "payroll." As the defendants established, pursuant to the ISO Manual, the class codes and corresponding premium bases and rates applicable to the work of adequately insured subcontractors is different from those applicable to work performed by uninsured or underinsured subcontractors.
The relevant portion of the plaintiffs' operations was initially assigned a particular class code that is applied when work is performed by an adequately insured subcontractor. After the one-year policy period ended, however, Inter-Reco conducted a premium audit, and determined that the plaintiffs did not have a certificate of insurance for one of their electrical subcontractors. Accordingly, the work performed by that subcontractor was reassigned a class code that is applied to work performed by uninsured or underinsured subcontractors, which class code corresponded to the premium base "payroll." According to the
The plaintiffs thereafter commenced the present action.
The defendants subsequently moved for summary judgment dismissing the complaint. They argued, among other things, that all of the plaintiffs' claims were barred by the filed rate doctrine. In support of that assertion, the defendants submitted part of the papers they filed (hereinafter the filing) with the Insurance Department in order to obtain approval of their proposed rates and rules for the Inter-Reco program. The filing, which was approved by the Insurance Department, included the independent contractor endorsement and the Exclusion.
The Supreme Court granted the defendants' motion in part. (2011 NY Slip Op 31202[U] [2011].) The court concluded that the plaintiffs' claim, which was asserted in all three causes of action, that they were improperly charged an additional premium for a risk that was excluded from coverage was barred
The plaintiffs appeal from so much of the order as granted that branch of the defendants' motion which was for summary judgment dismissing, in part, the cause of action alleging unjust enrichment insofar as asserted against Inter-Reco, and granted that branch of the defendants' motion which was for summary judgment dismissing the cause of action alleging a violation of General Business Law § 349. The defendants cross-appeal from so much of the order as awarded them summary judgment dismissing only in part the causes of action alleging breach of contract and unjust enrichment.
Although the Supreme Court awarded the defendants summary judgment dismissing, in part, the breach of contract cause of action, and although the plaintiffs argue in their brief that this was error, the plaintiffs' notice of appeal is limited to the portions of the order which awarded Inter-Reco summary judgment dismissing, in part, the unjust enrichment cause of action and awarded the defendants summary judgment dismissing the cause of action alleging a violation of General Business Law § 349. Thus, inasmuch as the notice of appeal is jurisdictional, the plaintiffs' arguments as to why the court erred in awarding summary judgment dismissing, in part, the breach of contract cause of action are not properly before this Court (see City of Mount Vernon v Mount Vernon Hous. Auth., 235 A.D.2d 516, 517
Before proceeding to the principal issue on appeal—the applicability of the filed rate doctrine—we conclude that the breach of contract and unjust enrichment causes of action should have been dismissed in their entirety, on different grounds. As to the breach of contract cause of action, the defendants argued that the plaintiffs did not sustain any damages because they did not pay the increased premium assessed after the audit. To recover damages for breach of contract, the plaintiffs must demonstrate "the existence of a contract, [their] performance pursuant to that contract, the defendants' breach of their obligations pursuant to the contract, and damages resulting from that breach" (Elisa Dreier Reporting Corp. v Global NAPs Networks, Inc., 84 A.D.3d 122, 127 [2011]; see JP Morgan Chase v J.H. Elec. of N.Y., Inc., 69 A.D.3d 802 [2010]). Here, the plaintiffs assert that Everest breached the insurance policy by charging a premium for their use of uninsured subcontractors, or, alternatively, by improperly calculating the premium owed for their use of uninsured subcontractors. However, the defendants demonstrated, prima facie, through the affidavit of an employee of Inter-Reco, that the plaintiffs never paid the challenged premium. The plaintiffs did not submit any evidence in opposition to raise a triable issue of fact as to whether they paid the premium. Thus, in opposition to the defendants' prima facie showing, the plaintiffs failed to raise a triable issue of fact as to whether they sustained any actual damages from Everest's alleged breach of contract.
Instead, in response to the defendants' showing, the plaintiffs rely upon cases indicating that "`[w]hen a party intends to resort to litigation in order to resist paying an unjust demand, that party should take its position at the time of the demand, and litigate the issue before, rather than after, payment is made,'" in order to avoid preclusion under the "voluntary payment doctrine" (Dillon v U-A Columbia Cablevision of Westchester, 292 A.D.2d 25, 27-28 [2002], affd 100 N.Y.2d 525 [2003], quoting Gimbel Bros. v Brook Shopping Ctrs., 118 A.D.2d 532, 535 [1986]).
For the same reason, the Supreme Court should have directed dismissal of the cause of action alleging that Inter-Reco was unjustly enriched in its entirety.
Here, the plaintiffs alleged that Inter-Reco was unjustly enriched because it received commissions for collecting the improper premium from the plaintiffs. Even assuming, theoretically, that such an unjust enrichment claim would be cognizable despite the fact that any commissions paid to Inter-Reco were not paid directly by the plaintiffs (cf. Sperry v Crompton Corp., 8 N.Y.3d 204, 215-216 [2007]; IDT Corp. v Morgan Stanley Dean Witter & Co., 12 NY3d at 142), the plaintiffs' unjust enrichment cause of action must be dismissed because the defendants demonstrated that the plaintiffs never paid the additional premium for which they claim Inter-Reco unjustly received commissions. Thus, because no part of any commissions received by Inter-Reco could be attributed to money paid by the plaintiffs for the challenged premium, Inter-Reco cannot have been unjustly enriched at the plaintiffs' expense.
The final cause of action, which alleged that the defendants violated General Business Law § 349 by charging a premium for an excluded risk, and sought injunctive relief for that alleged violation, is barred by the filed rate doctrine.
The "filed rate doctrine is supported by two distinct, albeit related, policy `strands'" —the nondiscrimination and justiciability strands (id. at 571; see Beller v William Penn Life Ins. Co. of N.Y., 8 A.D.3d 310, 313 [2004]; Marcus v AT & T Corp., 138 F.3d 46, 58 [2d Cir 1998]). The nondiscrimination rationale recognizes that "legislative bodies design agencies for the specific purpose of setting uniform rates" in order to prevent price discrimination, and that "allowing individual ratepayers to attack the filed rate `would undermine [that] scheme of uniform rate regulation'" (Beller v William Penn Life Ins. Co. of N.Y., 8 AD3d at 313, quoting Arkansas Louisiana Gas Co. v Hall, 453 U.S. 571, 579 [1981]; see Marcus v AT & T Corp., 138 F3d at 58). More specifically, without the filed rate doctrine, "a discriminatory system would result, with those having recourse to the courts paying less for the same services than other ratepayers who have either not sued, or who, having sued, are granted less substantial relief by different courts and juries" (Porr v NYNEX Corp., 230 AD2d at 569; see Keogh v Chicago & Northwestern R. Co., 260 U.S. 156, 163 [1922]).
The justiciability rationale was aptly described in Wegoland Ltd. as follows:
Here, the plaintiffs concede that the Insurance Department approved both the Exclusion and use of the ISO rating rules for assessing premiums related to the work of uninsured subcontractors. They assert, however, that the filed rate doctrine does not apply with respect to their claim that the defendant improperly charged a premium for an excluded risk because this is not a challenge to the filed rates or a request that the defendants "deviate from those rates." In making this assertion, the plaintiffs are essentially interpreting "rates" to be equivalent with "charges." It is true that the plaintiffs are not strictly challenging the rates applicable to particular risks, but are challenging the manner in which the premiums are calculated. The filed rate doctrine, however, encompasses such a challenge.
In American Telephone & Telegraph Co. v Central Office Telephone, Inc. (524 U.S. 214 [1998]), the United States Supreme Court clarified that the filed rate doctrine applies not only to charges, but to the "classifications, practices, and regulations affecting such charges" (id. at 223 [internal quotation marks omitted]; see also Kross Dependable Sanitation v AT & T Corp., 268 A.D.2d 874, 875 [2000]). In that respect, the Supreme Court observed: "Rates ... do not exist in isolation. They have meaning only when one knows the services to which they are attached" (American Telephone & Telegraph Co. v Central Office Telephone, Inc., 524 US at 223). The Court explained that "[i]f discrimination in charges [did] not include non-price features," then the carrier could circumvent the applicable regulatory scheme "by the simple expedient of providing an additional
In Porr v NYNEX Corp. (230 A.D.2d 564 [1997]), the plaintiff, a putative class member, sought to challenge the defendant NYNEX Corp.'s policy of charging for telephone calls in whole-minute increments, such that a call lasting one minute and one second would be billed as a two-minute call (id. at 567). The plaintiff claimed that this policy had not been stated plainly in the defendant's filing with the Public Service Commission, and had not been revealed to the public. This Court rejected the plaintiff's assertion, and the trial court's conclusion, that the essence of the complaint was not "`rate making', or the reasonableness or alleged excessiveness of a given rate" (id. [internal quotation marks omitted]). This Court concluded that "at the heart of the plaintiff's grievance [was his] suggestion that he was entitled to be billed `per second'" (id. at 575). Since the Public Service Commission had authorized the "`rounding up'" practice, however, the plaintiff's General Business Law § 349 claim was barred by the filed rate doctrine (id.). In so concluding, this Court implicitly recognized that it is not only the price charged to customers that is protected by the filed-rate doctrine, but, under certain circumstances, the manner in which the charges are calculated.
Similarly, in Matter of Concord Assoc. v Public Serv. Commn. of State of N.Y. (301 A.D.2d 828 [2003]), the petitioner, who had purchased a parcel of real property on which a hotel was situated, sought to challenge the manner in which it was billed for water service; specifically, it was billed at a flat rate for service, rather than a metered rate. The petitioner contended that billing it at a flat rate was unjust and unreasonable since its operations did not utilize the entire property, particularly, it did not use the hotel building (see id. at 829). The Appellate Division, Third Department, rejected the petitioner's claims as barred by the filed rate doctrine (see id. at 830-831).
In the present case, the plaintiffs seek to challenge, inter alia, the defendants' act of enhancing their premium due to their use
Aside from the fact that the filed rate doctrine was not addressed in that case, Home Ins. Co. v Chang is distinct from the present case. The insurance policy in that case only covered certain commercial transactions. Thus, the issue was whether the insured was required to declare a particular business transaction and pay premiums with respect to that transaction or whether, instead, the transaction was excluded from coverage. Here, the plaintiffs obtained commercial general liability coverage from Everest to cover any liability arising during the course of a construction project. There is no question that the plaintiffs engaged in a construction project covered by the commercial general liability policy. Although the plaintiffs frame the issue as one of whether they must pay a premium for excluded coverage, that is an oversimplified characterization of the issue. The issue is the manner in which the premium for the commercial general liability policy, under which the plaintiffs undisputedly had coverage, is calculated. The plaintiffs were not charged a separate premium for having used uninsured subcontractors. They were charged one premium, and into that calculation was factored their use of uninsured subcontractors.
The Insurance Department approved both the method of calculating premiums, including use of payroll as a base with respect to any uninsured subcontractors and the particular rate applied to the payroll base, as well as the use of the Exclusion. Since the method of calculating the plaintiffs' premium for a
The filed rate doctrine "is applied strictly to prevent a plaintiff from bringing a cause of action even in the face of apparent inequities whenever either the nondiscrimination strand or the nonjusticiability strand underlying the doctrine is implicated by the cause of action the plaintiff seeks to pursue" (Marcus v AT & T Corp., 138 F3d at 59). Here, both strands are implicated. If this Court were to determine that it was improper for the defendants to, effectively, enhance the plaintiffs' premium on the basis of its use of uninsured subcontractors, the plaintiffs "would have won for [themselves] a reduced rate" for their insurance policy, and nonparty insureds covered by identical policies, who also used uninsured subcontractors, "would of necessity pay a higher rate" (Porr v NYNEX Corp., 230 AD2d at 574). "Such a `discriminatory' result cannot be squared with the filed rate doctrine's mandate of equal rates for equal service" (id.).
As to the justiciability strand, as noted, the Insurance Department approved both the Exclusion for uninsured subcontractors and use of the ISO rating rules which provide for a different calculation of premiums where uninsured subcontractors are used. The courts lack the expertise to determine whether that method for calculating premiums is unreasonable in light of the exclusion from coverage of liability associated with the work of uninsured subcontractors (see generally Porr v NYNEX Corp., 230 AD2d at 572). It may be, for example, that despite the Exclusion, Everest's exposure related to the work of uninsured subcontractors is not zero. This type of determination is precisely one that is vested with the Insurance Department, which has the expertise and the tools to evaluate risks and costs borne by insurance companies (see City of New York v Aetna Cas. & Sur. Co., 264 AD2d at 304-305; Minihane v Weissman, 226 AD2d at 152; see generally Porr v NYNEX Corp., 230 AD2d at 572).
The plaintiffs additionally argue that while the Insurance Department approved both the Exclusion and the ISO rating rules for assessing premiums related to the work of uninsured subcontractors, the Insurance Department did not approve the simultaneous use of the Exclusion and those rating rules. In other words, it is the plaintiffs' position that the defendants were permitted, by the Insurance Department, either to exclude coverage for uninsured subcontractors or to charge increased
At bottom, the plaintiffs ask this Court to determine that the premium they were charged is not reasonable in light of the coverage provided, and to require Everest to recalculate their premium to, in the plaintiffs' view, more fairly comport with the coverage provided. However, such a "judicial determination of impropriety in the existing filed rates, which are at all times subject to the Superintendent's review, would offend the Legislature's determination to commit enforcement of the regulatory scheme to the Department of Insurance" (City of New York v Aetna Cas. & Sur. Co., 264 AD2d at 305; see Marcus v AT & T Corp., 138 F3d at 61; see generally Porr v NYNEX Corp., 230 AD2d at 575). Thus, the defendants were properly awarded summary judgment dismissing the plaintiffs' cause of action alleging violation of General Business Law § 349.
In light of our determination, we need not reach the parties' remaining contentions.
Therefore, the order is affirmed insofar as appealed from, and the order is reversed insofar as cross-appealed from, on the law, and those branches of the defendants' motion which were for summary judgment dismissing the cause of action to recover damages for breach of contract and the cause of action to recover damages for unjust enrichment insofar as asserted against the defendant Inter-Reco, Inc., are granted in their entirety.
Ordered that the order is affirmed insofar as appealed from; and it is further,
Ordered that the order is reversed insofar as cross-appealed from, on the law, and those branches of the defendants' motion which were for summary judgment dismissing the cause of action to recover damages for breach of contract and the cause of action to recover damages for unjust enrichment insofar as asserted against the defendant Inter-Reco, Inc., are granted in their entirety; and it is further,
Ordered that one bill of costs is awarded to the defendants.